Personalized Prescription Pads

Faculty members (not residents), Advanced Practice Nurses (NPs, CRNAs, and CNMs), and Physician Assistants who practice in hospital-based clinics and are credentialed to practice at the University of Maryland Medical Center, may obtain personalized versions of the standard prescriptions. Orders are placed by completing thePrescription Pad Order Form and faxing it to Medical Staff Services at 410-328-6433, attention Christine Drinks, Credentials Assistant. You can reach Christine at 410-328-2902.

The personalized blanks will match the standard blanks but will include information such as prescriber's name and phone number as well as the NPI. The prescriber's DEA number will not be pre-printed. A standard order will be 10 pads of non-controlled (#1000 blanks) and five pads of controlled (#250 blanks).

Once the order has been submitted, the practitioner/department will be contacted by the Pharmacy Department to pick up the order once completed. Please note that turnaround is estimated at 30-45 days. The contact person is Carre Fortman-Hunt, CPhT, Pharmacy Storeroom Lead Technician. She can be reached at 410.328.7755 or [email protected].

Please note that the order will not be placed until credentialing for hospital privileges has been completed.